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1.
Medicine (Baltimore) ; 96(42): e7935, 2017 Oct.
Article in English | MEDLINE | ID: mdl-29049188

ABSTRACT

This study aims to analyze the risk of venous thromboembolism (VTE) in patients receiving neoadjuvant chemotherapy (NACT) for epithelial ovarian cancer (EOC).A retrospective audit was conducted examining 147 patients treated for EOC. Surgical treatment with curative intent, with or without NACT and adjuvant chemotherapy, is the treatment approach, which was modified according to the patient's condition. The incidence of VTE with the most commonly used chemotherapy regimen, carboplatin, cisplatin, paclitaxel, docetaxel, and others were evaluated.This study found a 13.6% incidence of VTE in patients undergoing therapy with curative intent for EOC. No association was seen between NACT and VTE compared to VTE after standard treatment: 2/16 (12.5%) vs 5/131 (3.8%) (P = .16). Univariate and multivariate analyses also demonstrated that NACT has no risk for VTE with odds ratio (OR) = 0.89 (95% CI = 0.18-4.28) and P = 1. Results did not vary significantly with the type of chemotherapy used. Furthermore, increased incidence of VTE as an incidental finding supports the well-established role of malignancy in VTE occurrence. Univariate and multivariate analyses demonstrated that VTE occurred more frequently in menopausal women than nonmenopausal women (17.9% vs 5.8%) with OR = 3.55 (95% CI = 0.99-12.78) and P = .04 in patients aged ≥60 (19.3% vs 10%) with OR = 2.15 (95% CI = 0.83-5.57) and P = .13 but is not statistically significant.We conclude that NACT has no association with VTE and the currently used common chemotherapeutic drug combinations for ovarian cancer carry the minimal risk of thromboembolic events.


Subject(s)
Antineoplastic Agents/adverse effects , Chemotherapy, Adjuvant/adverse effects , Neoadjuvant Therapy/adverse effects , Neoplasms, Glandular and Epithelial/drug therapy , Ovarian Neoplasms/drug therapy , Venous Thromboembolism/epidemiology , Adult , Aged , Carcinoma, Ovarian Epithelial , Chemotherapy, Adjuvant/methods , Female , Humans , Incidence , Middle Aged , Neoadjuvant Therapy/methods , Retrospective Studies , Treatment Outcome , Venous Thromboembolism/chemically induced
2.
An Bras Dermatol ; 92(4): 553-555, 2017.
Article in English | MEDLINE | ID: mdl-28954111

ABSTRACT

Congenital self-healing reticulohistiocytosis is a rare, benign, self-limiting variant of Langerhans cell histiocytosis (LCH). LCH encompasses a group of idiopathic disorders characterized by the clonal proliferation of Langerhans cells. Congenital self-healing reticulohistiocytosis typically appears at birth or in the neonatal period as isolated cutaneous lesions, often appearing as multiple crusted papules with no systemic findings. Although clinical features seem aggressive, the lesions tend to involute spontaneously within weeks to a few months leaving residual hypo or hyperpigmented macules. Timely diagnosis with histology, immunocytochemistry, and electron microscopic studies will eliminate unnecessary therapeutic interventions. Although mostly self-resolving, it carries a variable clinical course in some patients with cases of extracutaneous involvement and/or recurrences. Hence, reassurance and long-term follow-up play key roles in the management of this disease.


Subject(s)
Histiocytosis, Langerhans-Cell/congenital , Skin Diseases/congenital , Female , Histiocytosis, Langerhans-Cell/pathology , Humans , Immunohistochemistry , Infant , Remission, Spontaneous , Skin Diseases/pathology
3.
An. bras. dermatol ; 92(4): 553-555, July-Aug. 2017. graf
Article in English | LILACS | ID: biblio-886984

ABSTRACT

Abstract: Congenital self-healing reticulohistiocytosis is a rare, benign, self-limiting variant of Langerhans cell histiocytosis (LCH). LCH encompasses a group of idiopathic disorders characterized by the clonal proliferation of Langerhans cells. Congenital self-healing reticulohistiocytosis typically appears at birth or in the neonatal period as isolated cutaneous lesions, often appearing as multiple crusted papules with no systemic findings. Although clinical features seem aggressive, the lesions tend to involute spontaneously within weeks to a few months leaving residual hypo or hyperpigmented macules. Timely diagnosis with histology, immunocytochemistry, and electron microscopic studies will eliminate unnecessary therapeutic interventions. Although mostly self-resolving, it carries a variable clinical course in some patients with cases of extracutaneous involvement and/or recurrences. Hence, reassurance and long-term follow-up play key roles in the management of this disease.


Subject(s)
Humans , Female , Infant , Skin Diseases/congenital , Histiocytosis, Langerhans-Cell/congenital , Remission, Spontaneous , Skin Diseases/pathology , Immunohistochemistry , Histiocytosis, Langerhans-Cell/pathology
4.
Exp Dermatol ; 26(11): 1112-1117, 2017 11.
Article in English | MEDLINE | ID: mdl-28603863

ABSTRACT

The biological connections between psoriasis and diabetes have been suggested by epidemiological, immunological and genetic studies. To identify additional shared susceptibility loci and investigate shared pathogenesis between these two diseases, we genotyped 89 reported diabetes susceptibility loci in 4456 psoriasis cases and 6027 controls of Chinese population using the MassARRAY system from Sequenom. We discovered three significant associations at rs6679677 on 1p13.2 (P=6.15×10-5 , OR=5.07), rs16861329 on 3q27.3 (P=2.02×10-4 , OR=0.87) and rs849135 on 7p15.1 (P=6.59×10-9 , OR=1.78), which suggested PTPN22, ST6GAL1 and JAZF1 as novel susceptibility genes for psoriasis in Chinese population. Our findings implicated the involvement of T-cell receptor signalling pathway in the pathogenesis of psoriasis and further confirmed the shared genetic susceptibility between psoriasis and diabetes.


Subject(s)
Antigens, CD/genetics , Diabetes Mellitus/genetics , Neoplasm Proteins/genetics , Protein Tyrosine Phosphatase, Non-Receptor Type 22/genetics , Psoriasis/genetics , Sialyltransferases/genetics , Adult , Asian People/genetics , Case-Control Studies , China , Co-Repressor Proteins , DNA-Binding Proteins , Female , Genetic Loci , Genetic Predisposition to Disease , Genotype , Humans , Male , Middle Aged , Polymorphism, Single Nucleotide , Psoriasis/immunology , Receptors, Antigen, T-Cell/metabolism , Signal Transduction/genetics
5.
Am J Trop Med Hyg ; 96(5): 1014-1018, 2017 May.
Article in English | MEDLINE | ID: mdl-28167593

ABSTRACT

AbstractDapsone is a bactericidal and bacteriostatic against Mycobacterium leprae, a causative agent of leprosy. Dapsone is also applied in a range of medical fields because of its anti-inflammatory and immunomodulatory effects. Dapsone hypersensitivity syndrome (DHS) is a rare yet serious adverse drug reaction (ADR) caused by dapsone involving multiple organs. We performed a systematic review of published articles describing dapsone-induced hypersensitivity syndrome, including all Chinese articles and the latest literature available in online databases published between October 2009 and October 2015. We determined the prevalence, clinical characteristics, and mortality rate of DHS. Importantly, we also summarized the recent advances in genetic testing allowing prediction of ADRs. In an initial systematic electronic search, we retrieved 191 articles. Subsequently, these articles were further filtered and ultimately 84 articles (60 Chinese case reports, 21 non-Chinese articles, and three epidemiological studies) were selected, which included 877 patients. The prevalence of DHS among Chinese patients was 1.5% with a fatality rate of 9.6%. Early withdrawal of dapsone and appropriate treatment reduced the fatality rate. Most importantly, genetic screening for the HLA-B*13:01 allele among high-risk populations showed a significant utility as a useful genetic marker to DHS. In conclusion, this review discusses the epidemiological and clinical characteristics of DHS among Chinese patients, which may help physicians to understand this syndrome.


Subject(s)
Dapsone/adverse effects , Drug Hypersensitivity/epidemiology , Drug Hypersensitivity/prevention & control , Genetic Testing/methods , HLA-B13 Antigen/genetics , Leprostatic Agents/adverse effects , Adolescent , Adult , Aged , Alleles , Child , China/epidemiology , Dapsone/administration & dosage , Drug Hypersensitivity/etiology , Drug Hypersensitivity/mortality , Drug Substitution/statistics & numerical data , Female , HLA-B13 Antigen/immunology , Humans , Leprostatic Agents/administration & dosage , Leprosy/drug therapy , Leprosy/microbiology , Male , Middle Aged , Mycobacterium leprae/drug effects , Prevalence , Primary Prevention/methods , Survival Analysis , Syndrome
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